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System Screening > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

R brain (L hemi) behavioral differences

A

Unilateral neglect L visual field Impulsive, poor judgment Overestimate abilities, unaware of impairments

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2
Q

Autonomic, behavior arrest, cognitive, emotional

A

Focal non-motor

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3
Q

Dementia: What are the different %’s

A

70% Alzheimer’s type 20% vascular (ischemic stroke: memory, cognition, social function)

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4
Q

Weber test

A

-Sound lateralization/localization -Tuning fork on middle of head

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5
Q

Cardinal features of PD

A

Rigidity, bradykinesia, resting tremor, postural instability (Trunk flexors > extensors), shuffle gait, festinating gait

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6
Q

Severity and duration of comas represented by:

A

Glasgow coma scale: 3-8: Severe head injury; coma 9-12: Moderate head injury; 9-10=coming out of coma 13-15: Mild head injury

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7
Q

PT management peripheral vestibular dysfunction

A
  • BPPV: Positional treatment
  • UVH/BVH: Gaze stability, gait, balance, habituation
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8
Q

L brain (R hemi) behavioral differences

A

Difficult communications (Aphasia) Negative, anxious, slow, careful Aware of impairments

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9
Q

Most common subtype of GBS:

A

AIDP

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10
Q

Divergence

A

Simultaneous outward movement of both eyes

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11
Q

CN IX and X

A

-Glossopharyngeal, Vagus -Gag reflex, swallow, taste

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12
Q

Strabismus

A

-Eye misalignment -Lack of coordination between extraocular muscles -Exotropia, Esotropia, Amblyopia

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13
Q

Injuries that cause cortical visual impairment

A

Stroke, TBI, seizure, hydrocephalus

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14
Q

Saccule

A

Vertical acceleration

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15
Q

Classifications of head trauma

A

-Primary: skull fx; gray matter contusion, diffuse white matter dmg -Secondary: Anoxia; swelling/ICP hematoma -Open: penetration, dura compromised -Closed: non-penetration; dura uncompromised

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16
Q

Describe the development of the nervous system in infants and children:

A

All neurons present, but not all connections are made Nervous system sensitive to insults

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17
Q

Consensual reflex

A

constrict in response to light in other eye

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18
Q

Presbyopia

A

-Farsighted -Not a corneal problem -Lens can’t focus -Lost lens elasticity -Bifocal lenses

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19
Q

Metastatic brain tumors:

A

Primary: Brain–>elsewhere Secondary: Elsewhere–>brain

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20
Q

What is the frontal lobe of the Cerebrum for?

A

Motor cortex: speech, Broca’s, decision making, problem solving, concentration, short-term memory, self-awareness, goal-orientation and drive, emotions and affect

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21
Q

Aspects of mental status:

A
  1. Level of consciousness: aware, orientx3, cooperative 2. Confusion: Inappropriate response, decreased attention 3. Lethargy: Drowsy, gives appropriate responses when aroused 4. Stupor: 1 step before coma, arousal for short period and slowed motor 5. Coma: Decorticate (UE flex, LE ext), Decerebrate (UE ext/IR, PF) 6. Delirium: TBI, withdrawal, confusion, anxiety, impaired memory/attention, illusions
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22
Q

Eye conditions associated with CP

A

Strabismus

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23
Q

Signs cortical visual impairment

A

-Color preference, vision loss, delay to visual stimuli, difficulty visualizing new surroundings, view close objects at close range and odd angles

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24
Q

Cortical visual impairment

A

-Decreased visual response d/t neurological problem affecting occipital cortex

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25
Q

Eye conditions associated with Hydrocephalus

A
  • Double vision, reduced vision, strabismus, amblyopia
  • Sunsetting sign: shunt
  • Increase CSF puts pressure on optic nerve
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26
Q

What types of body dysfunctions will be seen in Guillian-Berre syndrome?

A

Motor, sensory, autonomic

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27
Q

Describe the development of neurological systems in older adults:

A

-No change in cognitive function <60 unless pathology -Decreases in problem solving, short term memory, information process/new concepts -Verbal, inventories, long term memory in-tact

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28
Q

Medical treatment of Myasthenia gravis:

A

AChE inhibitor, thymus removal, immunosuppressant, plasmapheresis

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29
Q

Cognitive and behavioral changes after TBI measured by:

A

Ranchos Los amigos

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30
Q

Medical treatment for post-polio

A

Treatment and lifestyle modification, surgery/tendon transfer

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31
Q

Clinical features peripheral vestibular dysfunction

A

Normal smooth pursuit and saccades, positions bring nystagmus, hearing loss, mild ataxia, intense vertigo suppressed by visual fixation, slow and fast nystagmus, N/V

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32
Q

what is the parietal lobe of Cerebrum for?

A

Receive and process information

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33
Q

Rinne’s test

A
  • Tuning fork on mastoid
  • Tuning fork by ear
  • Ear time should be 2x longer than mastoid time
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34
Q

Peripheral vestibular dysfunction mechanisms

A

Mechanical

Decreased receptor input

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35
Q

CN XII

A
  • Hypoglossal
  • Tongue movement and strength
  • Tongue deviates toward weak side
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36
Q

Clinical features of Myasthenia gravis

A

Ptosis of eyelids, double vision, difficulty holding head upright, difficulty chewing meat or swallowing

Proximal weakness > distal

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37
Q

Meniere’s disease

A
  • Inner ear disorder
  • Too much fluid
  • Vertigo, tinnitus, hearing loss
  • Low Na, avoid caffeine/alcohol, diuretics
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38
Q

S/S MS:

A

Paresthesias, paresis, paralysis, spastic, fatigue, worsening vision, dysarthria, depression, bowel/bladder, sexual dysfunction

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39
Q

Retinal detachment

A
  • Retina pulls away
  • Floaters, flashes of light, curtain
  • Air or gas injection
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40
Q

PERRLA

A

Pupils equal

Round

Reactive to Light

responsive to Accommodation

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41
Q

Pupillary reflex

A

constrict in response to light

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42
Q

Retinoblastoma

A
  • Cancerous tumor of retina
  • Child <6
  • White pupil
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43
Q

Eye conditions associated with Fetal alcohol syndrome

A

-Refractive errors and strabismus

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44
Q

What to do during autonomic dysreflexia:

A

Sit pt up, check catheter or other irritants, get help if doesn’t subside

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45
Q

Medical treatment of GBS:

A

IVIg, plasmapheresis

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46
Q

Treatment of Retinoblastoma

A
  • Laser therapy 1st
  • Chemo and radiation after
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47
Q

Mechanical peripheral vestibular dysfunction

A
  • BPPV: Otoconia misplaced
  • Canalithiasis: otoconia float free
  • Cupololithiasis: Otoconia adhere
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48
Q

Features of post-polio

A

Decreased strength, myalgia, jt pain, increased atrophy and fatigue

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49
Q

Modified Ashworth Scale

A

0: No increase
1: Catch and release

1+: catch with min resistance through rest

2: Increase through ROM but easily moved
3: Passive movement difficult
4: Rigid flexion or extension

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50
Q

Automatisms, atonic, clonic, spasms, hyperkinetic

A

Focal motor

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51
Q

Physical Therapy and Myasthenia gravis:

A

Energy conservation techniques, isometric strength training, frequent rest

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52
Q

Pathology of PD

A

Substantia nigra stops making dopamine

53
Q

Diagnosis of MS

A

History, clinical findings, MRI (>2 lesions), CSF (elevated immunoglob), evoked potentials

54
Q

Common TBI caused throughout the ages

A

0-4: shaken baby; falls

15-24: MVA

65+: falls

55
Q

Post-polio

A

NM symptoms after polio, muscle fibers too stressed and retract, often will only be seen in >65 yoa

56
Q

Utricle

A

Horizontal acceleration

57
Q

CN I

A
  • Olfactory
  • Smell
  • test each nostril separately
58
Q

Vestibulo-ocular reflex (VOR)

A
  • Stabilize images in center of visual field
  • Eye movement opposite head movement
59
Q

Most common SCIs:

A

C5-C7; T12-L2

60
Q

Otoliths

A

Linear acceleration and gravity

61
Q

Subtypes of GBS:

A

AIDP, AMAN, ASAN, CIDP, Miller fisher (ataxia)

62
Q

Broca’s area location

Wernicke’s area location

A

Broca’s: frontal lobe

Wernicke’s: temporal lobe

63
Q

Most common form of PD:

A

Parkinsonism affecting BG

64
Q

CN V

A
  • Trigeminal
  • Face sensation: cotton ball
  • Clench teeth: palpate masseter
  • Corneal: cotton ball to eye
65
Q

Etiology of central vestibular dysfunction

A

UMN, stroke, TIA, MS, trauma

66
Q

Clinical findings of SCI

A

S/M impairment, spastic, orthostatic HTN, autonomic dysfunction (C3 and above require respirator), bowel/bladder/sex dysfunction

67
Q

Rinne’s test meaning

A
  • Normal: air conduction 2x bone
  • Conductive: Bone conduction longer or equal
  • Sensorineural: air conduction longer but not 2x
68
Q

S/S brain tumors:

A

Seizures, focal weakness, cognitive changes, behavioral changes

Interrupts sleep or worse upon wakening, elicited by postural changes, cough, sneeze, different than previous headache

69
Q

Limb weakness in Guillian-Berre syndrome vs Myasthenia Gravis

A

Guillian-Berre syndrome: Distal weakness > proximal

Myasthenia gravis: Proximal weakness > distal

70
Q

Goals for brain tumors

A

QOL; allow for changes in pt status

71
Q

Saccades

A

Quick, simultaneous movements of both eyes in same direction

72
Q

Anxiety:

A

Most common psychiatric disease

Anxiety/fear interacting with personal social and occupation function

Sweating, dizzy, restless fatigue

73
Q

Clinical features central vestibular dysfunction

A

Abnormal smooth pursuit or saccadic eye movements, diplopia, altered conscious, severe ataxia, slight vertigo not suppressed by visual fixation, vertical nystagmus, oscillate at equal speeds

74
Q

Guillian-Berre Syndrome

A

Autoimmune disease of acute inflammatory demyelination polyneuropathy that attacks myelin

75
Q

What direction does endolymph move

A

Opposite direction of head movements

76
Q

What are the different seizure disorders?

A
  • Mechanical: birth injury, head trauma, tumor, stroke
  • Metabolic: Electrolyte, glucose, metabolism error
  • Genetic: familial neonatal seizures, juvenile myoclonic epilepsy
  • Other: fever, infection
77
Q

Course of GBS:

A

Onset–>peak: 4 wks

Recovery: 2 yrs

Ambulation: ~6 mos

78
Q

what is the temporal lobe of cerebrum for?

A

Perception and interpretation of sounds, comprehension (wernickes), integration behavior, emotion, personality, long-term memory

79
Q

Myopia

A
  • Nearsighted
  • Cornea excessively curved or eye is too long
  • light in front of retina
80
Q

Autonomic dysreflexia

A

Pathological lesion if above T6;

Results in Increased BP and no vasodilation, bradycardia, severe pounding headache, Increased spasticity

81
Q

Describe the development of neurological systems in infants and children:

A
  • All neurons present but not all connections are made
  • Nerves are sensitive to insults
82
Q

Vestibulospinal reflex

A

Control of postural muscles to stabilize body/head in upright position

83
Q

Sudden, excess, abnormal electrical discharge of aggregates of neurons in brain

A

Seizures

84
Q

Describe the development of the nervous system in older adults:

A
  • No change in cognitive function <60 unless pathology
  • Decrease in problem solving, short-term memory, information processing and new concepts
  • In-tact verbal, inventories, and long term memory
85
Q

4 types of MS:

A
  • Relapse remit: Best prognosis
  • Secondary progressive
  • Primary progressive: Poor prognosis
  • Progressive relapse
86
Q

Weber test meaning

A
  • Normal: equal in both ears
  • Conductive: Sound more toward poor ear
  • Sensorineural: sound more toward good ear
87
Q

Eye conditions associated with Down Syndrome

A
  • Refractive errors
  • Strabismus
  • Presbyopia
  • Nystagmus
  • Cataracts
88
Q

Nystagmus

A
  • Involuntary eye movement part of VOR
  • Smooth pursuit in 1 direction
  • Saccadic movement in other direction
89
Q

Convergence

A

Simultaneous inward movement of both eyes

90
Q

Schizophrenia:

A

Onset: early adolescence, early adulthood

Severe persistent, psychotic syndromes resulting in detaching from reality

S/S: hallucinations, paranoid, inappropriate affect

91
Q

Describe the development of the nervous system in adolescents:

A

Continued intellectual maturation, develop abstract thinking, judgment, and values

92
Q

Semicircular canal

A

Angular acceleration

93
Q

Retinopathy of prematurity

A
  • Infants <3lb5oz
  • Retina BVs grow in abnormal fashion causing damage
  • Spontaneous resolvement
94
Q

What is the brainstem involved with?

A

reticular activation system, consciousness

95
Q

Glaucoma

A
  • High pressure damage optic nerve
  • Tunnel vision

-Medication, laser therapy, surgery

96
Q

Where are lesions found in Guillian-Berre Syndrome

A

PNS from Spinal n roots to distal motor and sensory

97
Q

Hyperopia

A
  • Farsighted
  • Insufficient curvature or eye is too short
  • light behind retina
98
Q

Changes to the brain d/t Alzheimers disease:

A

Plaques: collection of protein outside the brain

Tangles: Protein twists in abnormal twists in brain

99
Q

3 sensory systems that contribute to balance?

A

Vestibular, vision, somatosensory/proprioception

100
Q

Decreased receptor input peripheral vestibular dysfunction

A

UVH BVH: habituation

101
Q

Age related conditions

A

Cataracts, macular degeneration, glaucoma, diabetic retinopathy, retinal detachment

102
Q

PT and GBS

A

Prevent complications from immobilization, don’t overfatigue, maintain ROM, monitor strength, skin, educate, orthotics

103
Q

Why do we assess mental health?

A

Design best POC, safety, writing goals, referring, communication style

104
Q

Describe the development of neurological systems in adolescents:

A
  • Continued intellectual maturation
  • Abstract thinking
  • Judgment d/t education, intelligence, experience
  • Values
105
Q

PT and post-polio

A
  • General conditioning, don’t fatigue
  • Energy conservation techniques, orthotics
106
Q

Recurrent seizures caused by genetics, TBI, stroke, brain tumor, CP, infectious diseases, or unknown

A

Epilepsy

107
Q

PT management for Central vestibular dysfunction

A
  • Educate on safety and fall prevention
  • Gait training, balance, habituation
108
Q

Clinical features of GBS:

A

Ascend symmetrical: Motor and sensory impairments and autonomic symptoms, proximal weakness > distal, LE before UE, CN’s, No DTRs, Paresthesias, BP. HR, fatigue

109
Q

Macular degeneration

A
  • Tissue for center of visual field deteriorates
  • Medication, laser therapy, surgery
  • Dry
  • Wet: fluid/blood into macula
110
Q

CN VIII

A
  • Vestibulococchlear
  • Rinne’s
  • Weber
111
Q

Most common primary brain tumor

A

Glioma Glioblastoma: poor prognosis

112
Q

CN II

A
  • Optic
  • Visual acuity
  • Snellen wall chart (20/20)
  • test each eye separate
113
Q

Accomodation/convergence reflex

A

Pupil should constrict when finger is brought to nose

114
Q

CN III, IV, VI

A
  • Oculomotor, Trochlear, Abducens
  • CN VI: Lateral rectus AB
  • CN IV: Superior oblque down/in
  • CN III: rest of eye muscles
115
Q

Classification of seizures:

A

Focal (1 side)–>aware or non-aware–>motor or non-motor Generalized (diff. segments)–>motor or non-motor Unknown–>Motor or non-motor

116
Q

What we assess for mental status in patients

A

History, physical appearance/behavior, cognitive function, speech/language, emotional stability

117
Q

Chronic autoimmune inflammatory demyelination of CNS white matter; severing axons causing conduction block and LOF

A

MS

118
Q

Mania:

A

Elevated/euphoric or irritable/agitated mood >1wk Hyper, over confident, exaggerated self image, decreased need for sleep, poor social judgment

119
Q

Astigmatism

A

-Asymmetrical eye -Multiple focal points -Near and far blurry

120
Q

Cataracts

A

-Clouding of lens, blurry, night blind, fading/yellow colors -Surgery

121
Q

How to determine neurological levels for Sensory and Motor

A

Sensory: last normal dermatome Motor: Last normal myotome w/ 3/5

122
Q

Amblyopia

A

-Lazy eye -Decrease vision in 1 eye -Brain favors strong eye

123
Q

CN VII

A

-Facial -Wrinkle forehead -Close eyes -Show teeth -Puff cheeks

124
Q

Myasthenia gravis:

A

Autoimmune motor end plate disease causing decreased AcH receptors; reduced efficiency of neuromuscular transmission and easily fatigue able muscle activity

125
Q

CN XI

A

-Accessory -Upper trap and SCM strength -shrug shoulders and turn head

126
Q

Types of hematoma

A

-Acute epidural: tear meningeal artery between skull and dura mater; fast bleed -Acute subdural: Venous rupture between dura and arachnoid; long bleed over time

127
Q

Screening for depression:

A

-PHQ2: Yes to 2; refer out -Geriatric: >5/10=depression

128
Q

What is the limbic system involved with?

A

mediate behavior for survival (mating, fear, aggression, affection)

System Screening (2 decks)

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